Compendium of articles from recent surgical literature that address ethical issues chosen by surgeons.

The first textbook on the subject, this is a practical, clinically comprehensive guide to ethical issues in surgical practice, research, and education written by some of the most prominent figures in the fields of surgery and bioethics. Discussions of informed consent, confidentiality, and advance directives--core concepts integral to every surgeon-patient relationship--open the volume. Seven chapters tackle the ethical issues in surgical practice, covering the full range of surgical patients--from emergency, acute, high-risk, and elective patients, to poor surgical risk and dying patients. The book even considers the special relationship between the surgeon and patients who are family members or friends. Chapters on surgical research and education address innovation, self-regulation in practice and research, and the prevention of unwarranted bias. Two chapters focus on the multidisciplinary nature of surgery, including the relationships between surgery and other medical specialties and the obligations of the surgeon to other members of the surgical team. The economic dimensions of surgery, especially within managed care, are addressed in chapters on the surgeons financial relationships with patients, conflicts of interest, and relationships with payers and institutions. The authors do not engage in abstract discussions of ethical theory; instead, their discussions are always directly relevant to the everyday concerns of practicing surgeons. This well-integrated volume is intended for practicing surgeons, medical educators, surgical residents, bioethicists, and medical students.

Surgery inevitably inflicts some harm on the body. At the very least, it damages the tissue that is cut. These harms often are clearly outweighed by the overall benefits to the patient. However, where the benefits do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery. When, if ever, do the benefits of these surgeries outweigh their costs? May a surgeon perform dangerous procedures that are not clearly to the patient's benefit, even if the patient consents to them? May a surgeon perform any surgery on a minor patient if there are no clear benefits to that child? These and other related questions are the core themes of this collection of essays.

This book encompasses the theoretical and practical aspects of surgical ethics, with a focus on the application of ethical standards to everyday surgical practice and the resolution of ethical conflicts in the surgical arena. It provides surgeons (both prospective and practicing) in the different surgical fields with deep, practical insights into the topic. A 21st century surgeon requires complete competence (superb clinical skills, expert surgical decision-making and outstanding performance and technical skills) as well as solid ethical values. Ethics are placed at the core of surgical professionalism, so surgeons must be not only proficient and expert but also ethically and morally reliable. Surgical decision-making can be considered as a two-step process: the “how to treat” aspect is a matter of surgical science, while “why to treat” issues are a matter of surgical ethics and are based on ethical principles. As such, every surgeon should have a moral compass to guide his or her actions, always placing the welfare and rights of the patients above their own. The book provides invaluable background and insights for solving the ethical conflicts surgeons around the globe encounter in their daily practice. Each chapter will also include features such as key point summaries in the beginning of the chapters, explanatory boxes, a glossary and suggested readings. Surgical Ethics - Principles and Practice is an authoritative work in the field designed for experienced surgeons, surgical residents, and fellows, all of whom are confronted with ethics issues and conflicts in practice.

Over the last quarter of a century, the fields of medical ethics and of legal issues related to medical practice have rapidly developed for a number of reasons. Firstly, the provision of healthcare nowadays is based on a complicated partnership between healthcare providers, patients, administrators and organizations responsible for providing finance; this complicated partnership frequently results in clashes of views, opinions, and priorities, which have a major ethical and legal dimension. Secondly, a major event of the 21st century is the development of multicultural societies; healthcare-related decisions thus have to be made on the background of so many different ethnicities, religions, cultures and languages, resulting in a great spectrum of ethical and legal implications. Thirdly, in the modern world, people are more mobile and can easily and cost-effectively seek treatment outside of their country of origin or residence, which raises many ethical and legal issues. Lastly, the development of new medical specialties, modern and advanced treatments for very challenging patients, and the introduction of new technologies in medical practice have dramatically broadened the spectrum of ethical and legal issues related to medical practice. This book will therefore aim to cover in detail general principles and specific issues related to the ethical and legal dimensions of modern surgical practice.

Introductory Chapter: Introduction to Advanced Concepts in Endocarditis.

This instant gold standard title is a major contribution to the field of clinical medical ethics and will be used widely for reference and teaching purposes for years to come. Throughout his career, Mark Siegler, MD, has written on topics ranging from the teaching of clinical medical ethics to end-of-life decision-making and the ethics of advances in technology. With more than 200 journal publications and 60 book chapters published in this area over the course of his illustrious career, Dr. Siegler has become the pre-eminent scholar and teacher in the field. Indeed his work has had a profound impact on a range of therapeutic areas, especially internal medicine, pediatrics, surgery, oncology, and medical education. Having grown steadily in importance the last 30 years, clinical ethics examines the practical, everyday ethical issues that arise in encounters among patients, doctors, nurses, allied health workers, and health care institutions. The goal of clinical ethics is to improve patient care and patient outcomes, and almost every large hospital now has an ethics committee or ethics consultation service to help resolve clinical ethical problems; and almost every medical organization now has an ethics committee and code of ethics. Most significantly, clinical ethics discussions have become a part of the routine clinical discourse that occurs in outpatient and inpatient clinical settings across the country. This seminal collection of 46 landmark works by Dr. Siegler on the topic is organized around five themes of foundational scholarship: restoring and transforming the ethical basis of modern clinical medicine, the doctor-patient relationship, education and professionalism, end-of-life care, and clinical innovation. With introductory perspectives by a group of renowned scholars in medicine, Clinical Medical Ethics: Landmark Works of Mark Siegler, MD explains the field authoritatively and comprehensively and will be of invaluable assistance to all clinicians and scholars concerned with clinical ethics.

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.

Neurosurgical interventions have the potential to change a person's concept of self, as well as affect their neurological and cognitive function to an unacceptable level for both patient and family. In an increasingly complex and evolving field, the ethical implications of treatments and their eventual outcomes must be carefully balanced. Ethics in Neurosurgical Practice is a comprehensive and practical guide for managing the treatment of patients with debilitating neurosurgical conditions. Chapters address specific conditions, such as traumatic brain injuries, ischemic stroke and spinal surgery, and the ethical challenges that each of these pose. Detailed case studies present potential scenarios that readers might encounter, and their outcomes. Future developments of this fast-paced field are expanded upon, including televised live surgery and the ethical aspects of innovation in neurosurgery. A broad variety of contributors in different fields, including neurosurgeons, intensivists and bioethicists, ensures comprehensive coverage from a range of views and experiences.